EP1844721B1 - Externer Allzweck-Fixierer für orthopädische Verwendungen - Google Patents

Externer Allzweck-Fixierer für orthopädische Verwendungen Download PDF

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Publication number
EP1844721B1
EP1844721B1 EP07007259A EP07007259A EP1844721B1 EP 1844721 B1 EP1844721 B1 EP 1844721B1 EP 07007259 A EP07007259 A EP 07007259A EP 07007259 A EP07007259 A EP 07007259A EP 1844721 B1 EP1844721 B1 EP 1844721B1
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EP
European Patent Office
Prior art keywords
external fixator
shaped
load
ring
head
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Not-in-force
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EP07007259A
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English (en)
French (fr)
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EP1844721A1 (de
Inventor
Claudio Sinico
Enrico Castaman
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Permedica SpA
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Permedica SpA
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Publication of EP1844721A1 publication Critical patent/EP1844721A1/de
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like for external osteosynthesis, e.g. distractors, contractors
    • A61B17/64—Devices extending alongside the bones to be positioned
    • A61B17/6416—Devices extending alongside the bones to be positioned with non-continuous, e.g. hinged, pin-clamp connecting element
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like for external osteosynthesis, e.g. distractors, contractors
    • A61B17/66—Alignment, compression or distraction mechanisms

Definitions

  • This invention relates to an all-purpose external fixator particularly suitable for use in the field of orthopedic traumatology.
  • fixators that comprise a shock-absorbing deflection unit to enable the elastic deflection of the implant facilitates the optimal formation of the bone callus in the area affected by the fracture.
  • an all-purpose external fixator of known type that is widely used to create the above-mentioned implants is illustrated in the axonometric view in fig. 1 , where it is globally indicated by the letter A; it basically comprises a load-bearing rod B and a second load-bearing rod C, both developing mainly in the longitudinal plane, and connected together by means of a central member D.
  • each of the load-bearing rods B, C has a longitudinal slot Ba, Ca that slidingly contains one or more clamps E with associated connection elements F consisting of screws Fa that are inserted in the bone stumps M.
  • the load-bearing rods B, C are connected together by means of the above-mentioned central member D, which enables the former to be arranged in different positions because it comprises:
  • the surgeon takes action on the screw unit H and the articulated joint G to adjust the distance, offset, angle and reciprocal rotation of the load-bearing rods B, C.
  • the screw unit H also enables the patient to progressively adjust the distance between the load-bearing rods after the application of the implant, and thus facilitate the optimal formation of the bone callus at the site of the fracture Ma.
  • a first drawback consists in that it is impossible to maintain the coaxial or offset alignment of the load-bearing rods B, C when action is taken to adjust the angle of inclination of the articulated joint G, or to maintain the relative angle of inclination between the load-bearing rods when action is taken on the articulated joint G to adjust its coaxial or offset alignment.
  • the articulated joint comprises a screw Ga projecting from the central member G that is contained in a slot Gb in which the screw Ga is locked by means of a nut Gc and a washer Gd, whenever the nut Gc is loosened, the screw-slot pair becomes unstable and both the axial position, and the angle of inclination between the load-bearing rods B, C are consequently lost.
  • Another drawback lies in that it is impossible to keep the angle through which the load-bearing rods are reciprocally rotated in relation to a plane crosswise to their longitudinal axis constant whenever action is taken on the screw unit H to modify the axial distance between said load-bearing rods.
  • the screw unit which comprises a threaded sleeve Ha with a threaded ring nut Hb and a threaded counter ring nut He which contain a screw Hd belonging to one of the load-bearing rods (the load-bearing rod C in the case in point), is obviously unable to guarantee the stability of the angle through which the load-bearing rods are reciprocally rotated on a plane crosswise to their longitudinal axis when action is taken on the ring nuts to modify the axial distance between the load-bearing rods.
  • Another drawback lies in that the means of connection between the component parts of the fixator do not have structural features suitable for enabling a controlled fine adjustment of their displacements and locking positions, and in that the fixator affords no useful references to help identify precise adjustment positions and thereby obtain calibrated locking conditions.
  • the present invention aims to overcome all the above-listed drawbacks.
  • a first object of the invention is to realize an all-purpose external fixator for use in the field of orthopedic traumatology that enables the reciprocal angle of inclination of the load-bearing rods to be adjusted by modifying the inclination of each rod independently of the other.
  • fixator of the invention Another object achieved by the fixator of the invention is that the inclination of each of the load-bearing rods can be adjusted independently of any other adjustments.
  • fixator of the invention Another object achieved by the fixator of the invention is that the axial distance between the load-bearing rods is adjustable independently of any other adjustments.
  • fixator of the invention Another object achieved by the fixator of the invention is the opportunity to adjust the angle of reciprocal rotation of the load-bearing rods in a plane crosswise to their longitudinal axis independently of any other adjustments.
  • Another object of the invention is for the fixator to enable a fine adjustment of the reciprocal angle of rotation of the load-bearing rods in a plane crosswise to their longitudinal axis.
  • fixator of the invention lies in that the angle of inclination between the load-bearing rods, their axial distance and their reciprocal angular rotation in a plane crosswise to their longitudinal axis can each be adjusted independently of the others.
  • Another object achieved lies in that the adjustments of the fixator can be calibrated by the operator using operating means complete with controlled-torque and/or positioning-control regulators.
  • fixator of the invention allows for the elastic force of the shock absorber device inserted between the load-bearing rods to be adjusted without having to replace any component parts of the shock absorber device.
  • each of the articulated joints is of the hinged type and comprises a shaped head at each end of the central member, contained inside a fork provided at the end of each load-bearing rod.
  • hinged joints enable the angle of inclination of the load-bearing rods to be modified independently of one another.
  • the central member comprises a sleeve and a stem coaxial with one another, whose angular position in relation to a plane crosswise to their longitudinal axis can be varied by toothed means that can be locked in different positions.
  • the load-bearing rods can thus be rotated reciprocally around their longitudinal axis and locked in different angular positions independently of one another.
  • the angular position between the sleeve and the stem can be varied continuously using toothed regulating means comprising a toothed crown engaging with a toothed pinion that can be operated using controlled-torque or positioning-control regulating means.
  • the fixator is also provided with shock absorbing means that enable a deflecting movement of the load-bearing rods.
  • the means of connection between the component parts of the fixator are complete with operating devices that can be associated with motorized means, e.g. screwdrivers with controlled-torque or positioning-control regulators, to enable fine adjustments to be achieved.
  • motorized means e.g. screwdrivers with controlled-torque or positioning-control regulators
  • the fixator advantageously enables all the adjustments to be made independently of one another.
  • each adjustment does not interfere with other, previously- or subsequently-performed adjustments.
  • Another advantage lies in the opportunity to obtain fine adjustments of the component parts of the fixator, thereby improving its performance.
  • the external bone stump fixator forming the object of the invention is shown in a longitudinal view in fig. 2 , in a longitudinal sectional view in fig. 4 , and in an enlarged axonometric longitudinal sectional view in fig. 3 , globally indicated by the numeral 1.
  • first load-bearing rod 2 identifying a first longitudinal axis Ya along which there is a first longitudinal slot 3
  • a second load-bearing rod 4 identifying a second longitudinal axis Yb along which there is a second longitudinal slot 5
  • a central member lying mainly in the longitudinal plane and globally indicated by the numeral 6, that connects the two load-bearing rods 2, 4 together.
  • One or more clamps 7, 8 are slidingly coupled respectively in each of the slots, 3, 5 for holding screw connection elements 9, 10 for inserting in the bone stumps being connected together.
  • the clamps 7, 8 and the screw connection elements 9, 10 belong to the known state of the art and can be realized in various configurations and shapes suitable for enabling a better positioning of the former along the slots in the rods and a better grip on the bone stumps for the latter.
  • each end of the central member 6 co-operates with a corresponding end of the load-bearing rods to define articulated joints 11, 12, each of which comprises means 13, 14 for adjusting and means 15, 16 for locking the reciprocal position of the load-bearing rods 2, 3 with respect to the central member 6.
  • each of the above-mentioned articulated joints 11, 12 is of the hinged type and comprises a shaped head 17, 18 belonging to the central member 6 that is contained inside a fork 19, 20 belonging to each of the load-bearing rods 2, 4, and consisting of a fork stem 19a, 20a with a first prong 19b, 20b and a second prong 19c, 20c lying parallel to one another.
  • each shaped head may be obtained in the end of each of said load-bearing rods, while each of said forks may be obtained in the end of the central member.
  • Each shaped head 17, 18 and corresponding fork 19, 20 are revolvingly connected to one another by the above-mentioned adjustment means 13, 14 co-operating with the above-mentioned locking means 15, 16 to enable the various positions of the fixator to be established.
  • Each of the adjustment means 13, 14, as shown in figs. 3 , 7 and 8 comprises a revolving pin 21, 22 identifying a crosswise axis Xa, Xb at right angles to the axis Ya, Yb of the load-bearing rod 2, 3, which engages in a crosswise through hole 23, 24 provided both in the shaped head 17, 18 and in the fork 19, 20.
  • the pin 21, 22 has an operating head 21a, 22a at one end and, at the other end, a coaxial threaded hole 25, 26 in the revolving pin 21, 22 for containing a fixing screw 27, 28.
  • the operating head 21a, 22a has a polygonal profile and is contained in a corresponding seat 29, 30 with a polygonal profile provided in the first prong 19b, 20b of the fork 19, 20, as shown in fig. 2 .
  • the fixing screw 27, 28 has a head 31, 32, which abuts against the second prong 19c, 20c of the fork 19, 20 and which has a collar 33, 34 that engages in a hole 35, 36 provided in the second prong 19c, 20c.
  • the locking means 15, 16 comprise a pair of shaped jaws 40, 41; 42, 43 lying opposite one another and contained in a seat 44, 45 in the stem 19a, 20a of the fork 19, 20, with shaped surfaces 40a, 41 a; 42a, 43a in contact with the shaped head 17, 18.
  • the shaped jaws 40, 41; 42, 43 are also associated with an operating screw 46, 47 that has an operating head 48, 49 inserted in a recess 50, 51 provided in the stem 19a, 20a of the fork 19, 20 and a threaded body 52, 53 inserted in a through hole 40b, 42b provided in the first shaped jaw 40, 42 and with its threaded end screwed into a threaded hole 41c, 43c provided in the second jaw 41, 43.
  • the central member 6 comprises a sleeve 60 provided at one end with a first shaped head 18, in which a stem 61 (also shown in fig. 11 ) slidingly engages, with a second shaped head at the other end 17.
  • the sleeve 60 comprises a tubular member 62 (also shown in fig. 12 ) with the previously-mentioned first shaped head 18 at one end and, at the opposite end, a ring-shaped flange 63 (shown in detail in fig. 6 ) with a juxtaposed separate locking clamp 64 with a C-shaped crosswise profile, complete with a tangential locking screw 65, as shown in fig. 5 and also in fig. 13 .
  • a longitudinal reference plane 65 On the inside of the locking clamp 64 there is also a longitudinal reference plane 65 abutting against a longitudinal reference plane 66 provided on the outside of the stem 61 to enable the sliding longitudinal displacement of the stem 61 inside the sleeve 60 and thus enable the elongation of the fixator.
  • the ring-shaped flange 63 has a ring-shaped seat 67 in which a ring-shaped appendage 68 on the locking clamp 64 (shown in fig. 13 ) engages, the outer lateral surface 68a of said appendage bearing a set of teeth 69.
  • the previously-mentioned ring-shaped flange 63 also has a recess 70 for containing a toothed sector 71 (shown in fig. 10 ), the teeth 72 of which engage with the set of teeth 69.
  • the toothed sector 71 (shown particularly in figs. 3 , 4 , 6 and 10 ) is associated with screw fixing means 73 that are also coupled to the ring-shaped flange 63 and that comprise:
  • the engagement between the toothed sector 71 and the set of teeth 69 integrally attaches the ring-shaped flange 63 to the locking clamp 64, and the interference between the reference plane 65 and the longitudinal reference plane 66 prevents any rotation of the stem 61 in the sleeve 60, while the closure of the locking screw 65 prevents their reciprocal axial displacement in the longitudinal direction.
  • the tangential locking screw 65 of the clamp 64 simply needs to be loosened so as to disengage the toothed sector 71 from the set of teeth 69 on the ring-shaped flange 63 can be removed.
  • the sleeve 60 and the stem 61 can be manually rotated with respect to one another.
  • the position reached is locked by tightening the tangential locking screw 65 of the locking clamp 64 and the toothed sector 71 is locked in place by tightening the screw fixing means 73.
  • this adjustment can be made independently of any other adjustments and without affecting any such other adjustments.
  • FIG. 14 An alternative embodiment of the fixator of the invention is shown in fig. 14 , and in another view in fig. 15 , where it is globally indicated by the numeral 80.
  • the ring-shaped appendage 81 of the locking clamp 82 (shown in fig. 18 ) has a set of teeth 84 on the ring-shaped front surface 83 that engages with a pinion 85 associated with the end of an operating shaft 86 inserted in a hole 87 in the ring-shaped flange 88 (as shown in fig. 16 ).
  • the operating shaft 86 has an operating head 89 for coupling with operating means for use by the operator to rotate the pinion 85 so as to obtain controlled fine rotational adjustments of the sleeve 90 with respect to the stem 91.
  • the angular position of the sleeve 90 and stem 91 can thus be changed, for instance, using controlled-torque or positioning-control adjusting means connected to the operating head 89.
  • FIG. 19 Another embodiment of the fixator of the invention is shown in fig. 19 , where it is globally indicated by the numeral 100.
  • each load-bearing rod 102 comprises an adjustment device, globally indicated by the numeral 101, for the precision reciprocal rotation of each load-bearing rod 102 in relation to the central member 103 in line with each articulated joint 104.
  • each adjustment device 101 comprises a pin 105 with an operating head 106 positioned so as to pass through the fork 107 that, together with the shaped head 108, constitutes the articulated joint 104.
  • first set of teeth 109 that engages with a corresponding second set of teeth 110 on the outer surface of the shaped head 108.
  • the pin 105 has an axial threaded hole 111 for containing a fixing screw 112 for preventing the pin from being separated from the articulated joint.
  • Manual or motorized operating means are applied to the operating head 106 to rotate the pin 105 to induce the rotation of the load-bearing rod 102 with respect to the central member 103.
  • the operation and structural design of the adjustment device 101 are basically those of a worm screw and helical wheel type, which are characteristically irreversible.
  • Said alternative embodiment thus achieves the object of enabling a substantially micrometric, fine rotational adjustment of the load-bearing rods with a transmission ratio determined by the pitch of the teeth.
  • FIG. 20 Another embodiment of the fixator of the invention is shown in fig. 20 , where it is globally indicated by the numeral 150.
  • shock absorber device 151 can be applied to any of the previously-described embodiments of the fixator, not only to the embodiment described as an example herein.
  • the shock absorber device 151 comprises a tubular member 153 coaxially inserted between the sleeve 154 and the stem 155 forming the central member 152, and containing in turn an elastic assembly 156 that interacts between the end 157 of the tubular member 153 and adjustment means 158 contained inside the shaped head 159 of the stem 155.
  • the tubular element 153 contains a ring-shaped diaphragm 160 defining a first chamber 161 that slidingly contains the stem 155 and a coaxial second chamber 162 aligned in the direction of the first chamber 161 delimited by the end 157.
  • the elastic assembly 156 is contained partly inside the second chamber 162 and partly inside a coaxial hole 163 in the stem 155.
  • the elastic assembly 156 comprises a sliding rod 164 of which a first stretch 165 lies coaxially inside the hole 163 in the stem 155 and a second stretch 166 lies coaxially inside the second chamber 162, where said first stretch 165 and second stretch 166 are separated from one another by a counterflange 167 coaxial with the rod 164 and contained inside the second chamber 162.
  • the elastic assembly 156 also comprises a helical spring 168 which is contained, as shown, inside the second chamber 162 and on the outside of the second stretch 166 of the sliding rod 164, and which co-operates by contact with the counterflange 167 and the end 157.
  • the first stretch 165 of the sliding rod 164 has a rounded end 169 that cooperates in contact with the adjustment means 158.
  • the adjustment means 158 comprise an adjusting screw 171 contained inside a threaded hole 172 in the shaped head 159, with a conical body 173 placed in contact with the rounded end 169 of the sliding rod 164.
  • An operating head 173a on the adjusting screw 171 enables it to be screwed down or unscrewed in order to modify the position of the conical body 173.
  • tubular member 153 comprises a first part 178 partially engaging inside the sleeve 154 and a second part 179 with an outer thread 180 that are separated from one another by a ring-shaped flange 181.
  • a threaded ring nut 182 is coupled to the outer thread 180 and serves as a limiting device to adjust the range of motion of the load-bearing rods 174, 175 permitted by the shock absorber device 151.
  • Taking action on the adjustment means 158 thus enables a variation in the elastic force of reciprocal deflection between the load-bearing rods 174, 175, as well as in their range of motion, by modifying the position of the threaded ring nut 182 to obtain an optimal loading of the fractured area between the bone stumps.
  • the fixator of the invention clearly achieves all the previously-stated objects.
  • fixator of the invention may undergo changes and further embodiments differing from those illustrated and described herein that shall also be covered by the present patent if they come within the scope of the following claims.

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Claims (28)

  1. Fixateur externe (1; 80; 100; 150) für Knochenstümpfe zur orthopädischen Verwendung vom Typ, der Folgendes umfasst:
    - einen ersten lasttragenden Stab (2; 102; 174), der eine erste Längsachse (Ya) definiert und einen ersten Schlitz (3) enthält;
    - einen zweiten lasttragenden Stab (4; 175), der eine zweite Längsachse (Yb) definiert und einen zweiten Schlitz (5) enthält;
    - eine oder mehrere Klemmen (7, 8) , die gleitend in jedem der Schlitze (3, 5) eingreifen, um Verbindungselemente (9, 10) mit Schrauben zur Einführung in die Knochenstümpfe zu halten;
    - ein Mittelelement (6; 103; 152), das sich vorwiegend in Längsrichtung ausdehnt und mit beiden lasttragenden Stäben (2, 4; 102; 174, 175) verbunden ist,
    wobei jedes Ende des Mittelelements (6; 103; 152) mit einem entsprechenden Ende der lasttragenden Stäbe (2, 4; 102; 174, 175) zusammenwirkt, um Gelenksverbindungen (11, 12; 104) zu definieren, von denen jede Mittel (13, 14) zum Einstellen und Mittel (15, 16) zum Sperren der gegenseitigen Stellung der lasttragenden Stäbe (2, 4; 102; 174, 175) und des Mittelelements (6; 103; 152) aufweisen,
    dadurch gekennzeichnet, dass jede der Gelenksverbindungen (11, 12; 104) vom Scharniertyp ist und einen Formkopf (17, 18; 108, 159) umfasst, der in eine Gabel (19, 20; 107) passt, die von einem Gabelstiel (19a, 20a) mit einer ersten Zinke (19b, 20b) und mit einer zweiten Zinke (19c, 20c), die parallel zueinander liegen, definiert ist, wobei der Formkopf (17, 18; 108, 159) und die Gabel (19, 20; 107) durch das Einstellmittel (13, 14) drehbar miteinander verbunden sind und durch das Dazwischenanordnen des Sperrmittels (15, 16) gegenseitig wechselwirken.
  2. Fixateur externe (1; 80; 100; 150) nach Anspruch 1), dadurch gekennzeichnet, dass jeder der Formköpfe (17, 18; 108, 159), den jede der Gelenksverbindungen (11, 12; 104) umfasst, in jedem Ende des Mittelelements (6; 103; 152) ausgebildet ist, und jede der Gabeln (19, 20; 107) im Ende eines jeden lasttragenden Stabs (2, 4; 102; 174, 175) ausgebildet ist.
  3. Fixateur externe (1; 80; 100; 150) nach Anspruch 1), dadurch gekennzeichnet, dass jedes der Einstellmittel (13, 14) einen Drehzapfen (21, 22) umfasst, der im Inneren eines Durchgangslochs (23, 24), das transversal im Formkopf (17, 18; 108, 159) und in der Gabel (19, 20; 107) ausgebildet ist, gekoppelt ist und an einem Ende einen Betätigungskopf (21 a, 22a) und am gegenüberliegenden Ende ein Gewindeloch (25, 26) aufweist, das koaxial zum dem Drehzapfen (21, 22) ist und eine Fixierschraube (27, 28) enthält.
  4. Fixateur externe (1; 80; 100; 150) nach Anspruch 3), dadurch gekennzeichnet, dass der Betätigungskopf (21 a, 22a) ein polygonales Profil aufweist und im Inneren eines entsprechenden Sitzes (29, 30) mit polygonalem Profil in der ersten Zacke (19b, 20b) der Gabel (19, 20; 107) aufgenommen ist.
  5. Fixateur externe (1; 80; 100; 150) nach Anspruch 3), dadurch gekennzeichnet, dass die Fixierschraube (27, 28) einen Kopf (31, 32), der an der zweiten Zacke (19c, 20c) anstößt, sowie einen Bund (33, 34), der im Inneren eines Lochs (35, 36) in der zweiten Zacke (19c, 20c) eingreift, aufweist.
  6. Fixateur externe (1; 80; 100; 150) nach Anspruch 1), dadurch gekennzeichnet, dass die Sperrmittel (15, 16) ein Paar aus gegenüberliegenden Formbacken (40, 41; 42, 43) umfassen, die in einer Ausnehmung (44, 45) im Stiel (19a, 20a) der Gabel (19, 20) aufgenommen sind, in Kontakt zum Formkopf (17, 18; 108, 159) angeordnet sind und mit einer Betätigungsschraube (46, 47) in Verbindung stehen, um das Paar aus Formbacken (40, 41; 42, 43) gegen den Formkopf (17, 18; 108, 159) zu drücken.
  7. Fixateur externe (1; 80; 100; 150) nach Anspruch 6), dadurch gekennzeichnet, dass die Betätigungsschraube (46, 47) einen Betätigungskopf (48, 49) umfasst, der in einer Ausnehmung (50, 51) im Stiel (19a, 20a) der Gabel (19, 20; 107) eingeführt ist und an einem Ende eines Gewindekörpers (52, 53) angeordnet ist, der in einem Durchgangsloch (40b, 42b) in einer ersten (40, 42) der Formbacken eingeführt ist und dessen Gewindeende in ein Gewindeloch (41 c, 43c) in einer zweiten (41, 43) der Formbacken eingeschraubt ist.
  8. Fixateur externe (1; 80; 100; 150) nach Anspruch 2), dadurch gekennzeichnet, dass das Mittelelement (6; 103; 152) Folgendes umfasst:
    - eine Hülse (60) mit einem ersten Formkopf (18) an einem Ende;
    - einen Stiel (61; 155), der gleitend in die Hülse (60) eingreift, mit einem zweiten Formkopf (17; 159) an einem Ende und einer Längsbezugsebene (66) an der Außenseite.
  9. Fixateur externe (1; 80; 100; 150) nach Anspruch 8), dadurch gekennzeichnet, dass die Hülse (60) Folgendes umfasst:
    - ein röhrenförmiges Element (62) mit dem ersten Formkopf (18) an einem Ende und einem ringförmigen Flansch (63) am gegenüberliegenden Ende;
    - eine Sperrklemme (64; 82) mit einem C-förmigen Querschnittsprofil, die am ringförmigen Flansch (63; 88) anstößt und eine tangentiale Befestigungsschraube (65) aufweist.
  10. Fixateur externe (1; 80; 100; 150) nach Anspruch 9), dadurch gekennzeichnet, dass die Sperrklemme (64; 82) eine Längsbezugsebene (65) an der Innenseite aufweist, die zur Längsbezugsebene (68) an der Außenseite des Stiels (61; 105) hinweist und in Gleitkontakt zu dieser ist.
  11. Fixateur externe (1; 80; 100; 150) nach Anspruch 9), dadurch gekennzeichnet, dass der ringförmige Flansch (63; 88) eine ringförmige Ausnehmung (67) aufweist, in der ein ringförmiger Ansatz (68; 81) eingreift, der an der Sperrklemme (64; 82) ausgebildet ist und der an der äußeren Seitenoberfläche (68a) einen Satz Zähne (69) aufweist, die in entsprechende Zähne (72) eines gezahnten Bereichs (71), der in einer Ausnehmung (70) im ringförmigen Flansch (63) aufgenommen ist, eingreifen.
  12. Fixateur externe (1; 80; 100; 150) nach Anspruch 11), dadurch gekennzeichnet, dass der gezahnte Bereich (71) mit Schraubfixiermitteln (73) im Inneren des ringförmigen Flanschs (63) gekoppelt ist.
  13. Fixateur externe (1; 80; 100; 150) nach Anspruch 12), dadurch gekennzeichnet, dass die Schraubfixiermittel (73) Folgendes umfassen:
    - eine erste Schraube (74), die im Inneren eines Gewindelochs (75) im ringförmigen Flansch (63) gekoppelt ist und mit einem Betätigungskopf (76) ausgestattet ist;
    - eine koaxiale zweite Schraube (77), die im Inneren der ersten Schraube (74) an jener Seite, die dem Betätigungskopf (76) gegenüberliegt, gekoppelt ist, wobei ihr Ende (78) mit dem gezahnten Bereich (71) gekoppelt ist.
  14. Fixateur externe (80) nach Anspruch 11), dadurch gekennzeichnet, dass der ringförmige Ansatz (81) der Sperrklemme (82) an seiner ringförmigen Vorderfläche (83) einen Satz Zähne (84) aufweist, die in ein Zahnrad (85) eingreifen, das mit dem Ende einer Betätigungswelle (86) in Verbindung steht, welche in einem Loch (87) im ringförmigen Flansch (88) eingeführt ist.
  15. Fixateur externe (80) nach Anspruch 14), dadurch gekennzeichnet, dass die Betätigungswelle (86) an jenem Ende, das dem Zahnrad (85) gegenüberliegt, einen Betätigungskopf (89) zur Kopplung mit Betätigungsmitteln aufweist.
  16. Fixateur externe (100) nach Anspruch 1), dadurch gekennzeichnet, dass er eine Vorrichtung (101) zum Einstellen der gegenseitigen Drehung eines jeden der lasttragenden Stäbe (102) in Bezug auf das Mittelelement (103) umfasst, wobei die Einstellvorrichtung (101) an jeder der Gelenksverbindungen (104) angeordnet ist.
  17. Fixateur externe (100) nach Anspruch 16), dadurch gekennzeichnet, dass die Einstellvorrichtung (101) Folgendes umfasst:
    - einen Zapfen (105), der mit einem Betätigungskopf (106) ausgestattet ist, der durch die Gabel (107) und den Formkopf (108), die die Gelenksverbindung (104) definieren, tritt;
    - einen ersten Satz Zähne (109), der um den Umfang herum am Zapfen (105) bereitgestellt ist;
    - einen zweiten Satz Zähne (110), der an der Außenoberfläche des Formkopfs (108) bereitgestellt ist.
  18. Fixateur externe (100) nach Anspruch 17), dadurch gekennzeichnet, dass der Zapfen (105) gegenüber dem Betätigungskopf (106) ein axiales Gewindeloch (111) aufweist, das eine Fixierschraube (112) enthält.
  19. Fixateur externe (150) nach Anspruch 8), dadurch gekennzeichnet, dass er eine Stoßdämpfungseinrichtung (151) aufweist, die mit dem Mittelelement (152) in Verbindung steht.
  20. Fixateur externe (150) nach Anspruch 19), dadurch gekennzeichnet, dass die Stoßdämpfungseinrichtung (151) ein röhrenförmiges Element (153) umfasst, das koaxial zwischen der Hülse (154) und dem Stiel (155) angeordnet ist und eine elastische Anordnung (156) enthält, die zwischen dem Ende (157) des röhrenförmiges Elements (153) und Einstellmitteln (158), die im Inneren eines Formkopfs (159) des Mittelelements (152) aufgenommen sind, wechselwirkt.
  21. Fixateur externe (150) nach Anspruch 20), dadurch gekennzeichnet, dass das röhrenförmige Element (153) eine ringförmige Membran (160) enthält, die Folgendes definiert:
    - eine erste Kammer (161), in der der Stiel (155) gleitend aufgenommen ist;
    - eine koaxiale zweite Kammer (112), die vom Ende (157) abgegrenzt ist und mit der ersten Kammer (161) ausgerichtet ist;
    wobei die elastische Anordnung (106) teilweise im Inneren der zweiten Kammer (112) und teilweise in einem axialen Loch (113), das im Stiel (105) ausgebildet ist, aufgenommen ist.
  22. Fixateur externe (150) nach Anspruch 21), dadurch gekennzeichnet, dass die elastische Anordnung (156) einen gleitenden Stab (164) umfasst, von dem ein erster Abschnitt (165) koaxial im Inneren des axialen Lochs (163) im Stiel (155) liegt und ein zweiter Abschnitt (166) koaxial im Inneren der zweiten Kammer (162) liegt, wobei der erste Abschnitt (165) und der zweite Abschnitt (166) durch einen Gegenflansch (167) voneinander getrennt sind, der koaxial zum gleitenden Stab (164) ist und im Inneren der zweiten Kammer (162) aufgenommen ist.
  23. Fixateur externe (150) nach Anspruch 22), dadurch gekennzeichnet, dass die elastische Anordnung (156) ferner eine Spiralfeder (168) umfasst, die im Inneren der zweiten Kammer (162) aufgenommen ist, um den zweiten Abschnitt (166) des gleitenden Stabs (164) angeordnet ist und durch Kontakt mit dem Gegenflansch (167) und dem Ende (157) zusammenwirkt.
  24. Fixateur externe (150) nach Anspruch 22), dadurch gekennzeichnet, dass der erste Abschnitt (165) des gleitenden Stabs (164) ein abgerundetes Ende (169) aufweist, das durch Kontakt mit den Einstellmitteln (158) zusammenwirkt.
  25. Fixateur externe (150) nach Anspruch 24), dadurch gekennzeichnet, dass die Einstellmittel (158) eine Regulierschraube (171) umfassen, die im Inneren eines Gewindelochs (172) im Formkopf (159) aufgenommen ist und einen Betätigungskopf (173a) und einen konischen Körper (173) aufweist, der in Kontakt zum abgerundeten Ende (119) des gleitenden Stabs (164) angeordnet ist.
  26. Fixateur externe (150) nach Anspruch 22), dadurch gekennzeichnet, dass der erste Abschnitt (165) des gleitenden Stabs (164) einen Durchgangsschlitz (176) aufweist, der einen Bezugszapfen (177) enthält, der quer zum röhrenförmigen Element (153) liegt.
  27. Fixateur externe (150) nach Anspruch 20), dadurch gekennzeichnet, dass das röhrenförmige Element (153) einen ersten Teil (178), der teilweise im Inneren der Hülse (154) eingreift, und einen zweiten Teil (179) mit einem Außengewinde (180) aufweist, wobei die beiden Teile durch einen ringförmigen Flansch (181) voneinander getrennt sind.
  28. Fixateur externe (150) nach Anspruch 27), dadurch gekennzeichnet, dass eine ringförmige Gewindemutter (182) mit dem Außengewinde (180) am zweiten Teil (179) des röhrenförmigen Elements (153) gekoppelt ist.
EP07007259A 2006-04-05 2007-04-05 Externer Allzweck-Fixierer für orthopädische Verwendungen Not-in-force EP1844721B1 (de)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
IT000101A ITVI20060101A1 (it) 2006-04-05 2006-04-05 Fissatore esterno polivalente per uso ortopedico

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EP1844721B1 true EP1844721B1 (de) 2009-12-02

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WO2012122317A2 (en) * 2011-03-07 2012-09-13 Conventus Orthopaedics, Inc. Apparatus and methods for bone repair preparation
ITVI20130135A1 (it) * 2013-05-16 2014-11-17 Enrico Castaman Fissatore esterno ad uso ortopedico.
CN107080581B (zh) * 2016-02-16 2020-08-11 宋若怡 弹性内固定系统及可调压固定棒
CN107080582B (zh) * 2016-02-16 2020-08-11 宋若怡 弹性脊柱固定系统及可调压固定棒
CN107049518B (zh) * 2017-04-17 2023-08-25 上海长海医院 一种前列腺穿刺活检术体位固定器
WO2020092049A1 (en) * 2018-10-30 2020-05-07 Smith & Nephew, Inc. External fixation strut
CN111352225B (zh) * 2020-04-10 2023-07-28 武汉万屏电子科技有限公司 一种扫描显微成像角度修正的辅助装置及方法
CN111568518B (zh) * 2020-04-16 2021-06-25 洪磊 一种微创经皮固定腕舟骨的外固定支架

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CH638390A5 (en) * 1979-08-06 1983-09-30 Poldi Spojene Ocelarny Narodni Device for the fixation of bones
DE3701533A1 (de) 1987-01-21 1988-08-04 Medi System Gmbh Osteosynthesehilfsmittel
GB2280608A (en) * 1993-08-05 1995-02-08 Hi Shear Fasteners Europ Ltd External bone fixator
IT1298413B1 (it) * 1997-05-21 2000-01-05 Orthofix Srl Dispositivo minifissatore esterno per il trattamento di ossa piccole

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ATE450218T1 (de) 2009-12-15

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